I have written here extensively about the various "scheduling based codes" and their usage - or lack of usage - among pediatricians, but have made the mistaken assumption that most of you reading here actually have extended office hours.

It is this pediatric practice management consultant's position that if you are not offerring office hours to your patients outside standard working hours, you're not only doing your patients a disservice, but yourself as well.

Why? Because so many of your parents are from families where both parents work or from single parents who work. And making them come to your office in the middle of their work day adds another variable to the mix which just might - and often does - push them over the edge into not coming into your office. I hear so many complaints about Medicaid patients not coming in for their visits...how many of them simply can't afford or are not allowed to leave work?

It's also been my experience that many of the practices who complain or worry most about the minute clinics are the ones who don't conciously recognize the single thing the clinics are better at: access.

So, here's some good data from the primary care arena. A hospital expands its hours and sees volume jump. To quote:

"People really don't want to leave their jobs and come to our offices [during their work hours]," said Dr. Paul Whelton, chief executive of Loyola University Health System, parent of the medical center. "Physicians are making themselves more available. We need to be much more user-friendly.

Here's a telling line:

The American Academy of Family Physicians said 42.4 percent of the doctors it surveyed last year provided "extended office hours."

I draw two and a half conclusions from this:

I'll bet that the AAP has no data about their members and how many offer extended office hours. Sad. Someone prove me wrong.

Presuming that pediatricians are in the same ballpark (they might even be worse), the implication is that an immediate change you can/should make to your practice to distinguish you is to offer those pre-9am, post-5pm office hours! And you get paid more, too.